NPIMap

Individual provider Active NPI

Richard Joseph Mateyka, PA-C

  • Surgical Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1912985367
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA699 Issued in NV
Practice address
2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609
Phone
(702) 731-1616
Fax
(702) 734-4900
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 699 NV
Surgical Physician Assistant 363AS0400X PA699 NV Primary

Addresses

Primary practice location

2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609

Mailing address

2800 E Desert Inn Rd Ste 100
Las Vegas, NV 89121-3609
Phone (702) 731-1616

Other practice location 1

8402 Centennial Pkwy
Las Vegas, NV 89149-4792
Phone (702) 869-3486

Other identifiers 4

IdentifierTypeStateIssuer
CC2485OtherBXBS
970024992OtherR.R. MEDICARE
2402056MedicaidNV
1912985367MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101111000699 NV Practitioner - Physician Assistant 2163617507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
The Hahneman Medical College and Hospital, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Orthopaedic Center LTDGroup PAC ID 6406759661, 103 clinicians

Practice addresses (Care Compare)

2800 E Desert Inn Rd
Suite 100
Las Vegas, NV 89121-3609
Phone (702) 731-1616

8402 Centennial Pkwy
Suite 240
Las Vegas, NV 89149-4793
Phone (702) 731-1616

Hospital & facility affiliations

  • Spring Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290046
  • Valley Hospital Medical Center Hospital, Las Vegas, NV, CCN 290021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
699NVMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Valley Medical Center Past Accepting new patients
Desert Springs Hospital Past Accepting new patients
Sunrise Mountainview Hospital, Inc. Past Accepting new patients
Desert Orthopaedic Billing LLC Orthopaedic Surgery Past Accepting new patients
Dignity Health Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: matrj@doclv.emadirect.md

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1912985367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E DESERT INN RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213609",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E DESERT INN RD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891213609",
            "telephone_number": "702-731-1616",
            "fax_number": "702-734-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8402 Centennial Pkwy",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891494792",
            "country_code": "US",
            "telephone_number": "702-869-3486",
            "fax_number": "702-869-3542",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATEYKA",
        "first_name": "RICHARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "699",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BXBS",
            "identifier": "CC2485",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R. MEDICARE",
            "identifier": "970024992",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2402056",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912985367",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.